Reducing Childhood Trauma Through Home Visiting

Today’s generation of children is experiencing more childhood trauma than their parents’ generation.

They may be in homes with abuse, neglect, drug and alcohol use, mental illness, and domestic violence. They may have had their family life rocked by divorce, or a family member die, deported or sent to prison.

These stressful and traumatic experiences within the family in the first 18 years of life are called Adverse Childhood Experiences or ACEs. The effects of ACEs can start early and last a lifetime, showing up as development, academic, health and behavior issues. And they can lead to ACEs for a new generation. Parents who had high numbers of ACEs are 14 times more likely to be coping with life in ways that make ACEs for their children.

But trauma does not have to determine destiny. We now understand how adversity becomes embedded into biology, behavior and risk, and how simple supports and opportunities can deliver stunning improvement in peoples’ lives.

Toolkit Helps Home Visitors Effectively and Safely Address ACEs

Parents are the key to reducing childhood trauma. And home visitors are in one of the best positions to help parents understand events of the past and how to protect their children now and in the future.

Home visitors are trained professionals who support and strengthen families in those first years of life. They talk with parents about prenatal care, infant care, child development and parenting skills and are highly skilled in building trusting relationships and creating safe spaces for meaningful conversations.

Several years ago, home visitors knowledgeable about ACEs research wanted to bring this information to families but worried about causing harm. In 2015, the NEAR@Home toolkit was launched to address these concerns and provide strategies for engaging parents in discussing ACEs in a safe, respectful and effective way for both the home visitor and family.

Since then, the free toolkit has been downloaded more than 3,500 times by people from all 50 states, Puerto Rico, District of Columbia, and 11 countries.

NEAR, the acronym for Neuroscience, Epigenetics, Adverse Childhood Experiences and Resilience, represents three decades of scientific research into the power of childhood adversity on biology, behavior and risk – and how it can be passed on to future generations.

“It is one of the largest public health discoveries of our time,” said Quen Zorrah, Thrive Washington’s NEAR@Home Facilitator and a national lead on integrating this work into home visiting programs. “Parents have the right to know the most powerful determinant of their children’s future health, safety and productivity.”

Created, reviewed and tested by home visitors, mental health providers and other experts in Region X (Alaska, Idaho, Oregon and Washington), the NEAR@Home toolkit is a training manual with guided processes to help home visitors learn and practice language and strategies to safely and effectively talk with families about the wide-ranging and long-term effects of childhood trauma — and strategies to buffer these experiences and build resilience for both the parent and child.

Talking about ACEs is not about creating excuses but understanding experiences

Research finds that parents with a history of childhood trauma will often use this new understanding of their past to begin to heal and learn how to protect their children from trauma.

“NEAR@Home has been such a profoundly meaningful tool in my practice. It has opened the door for deeper, more meaningful conversations, insights and understanding,” said Erika, a home visitor in Washington state. “One of my clients said, ‘I know those things that happened to me were really bad, but I believe they have made me a stronger and better person.’”

Because of the success of the toolkit, Region X was awarded a 2017 federal Innovation Grant through the Maternal, Infant and Early Childhood Home Visiting program to pilot an expansion across its four states.

How Philanthropy Can Help

• Get informed about ACEs. Read the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study, one of the largest investigations of childhood abuse and neglect and later-life health and well-being. Also check out ACEs Connection, an online network supporting communities wanting to address and prevent ACEs. This site also has an online ACEs questionnaire for those wanting to discover their own ACE score.
• Support the expansion of the NEAR@Home toolkit. The Region X pilot to expand and deepen use of the toolkit among home visitors is almost complete. Capacity is now needed to train and support home visitors after they’ve downloaded the toolkit. Home visiting is one of the earliest and most effective actions we can collectively take to lessen and end the intergenerational cycle of ACEs.

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Original contribution by Molly O’Connor, Executive Vice President of External Affairs at Thrive Washington